In Defense of Case Reports and Case Series

  title={In Defense of Case Reports and Case Series},
  author={Jan Paul Vandenbroucke},
  journal={Annals of Internal Medicine},
Readers of the medical literature wonder whether they should still make time to read case reports and case series. How should they balance this time-honored cornerstone of the medical literature with the demands of modern evidence-based medicine? Case reports and case series have been subject to some serious questioning. It has been said that more often than not, new ideas from case reports are not sustained on further research, that case reports contain misleading elements in clinical… 

Time for a new approach to case reports.

An Overview of Reports on Clinical Case Report

From late 1970s in scientific community there was a tendency to see the case report as least important and a 'second class' publication, so the authors tried to find out how 'fertile seeds' were cultivated and valued by the scientific community.

Tips and tricks to make case report.

  • I. Alwi
  • Medicine
    Acta medica Indonesiana
  • 2007
Keep in mind the basic reason for writing a case report: namely, that it should have a message for the reader, and then select a journal whose readership will include the target audience.

The dilemma of the editors: Should or should not the case report be accepted for publication?

Case reports are useful in two aspects of medicine: on one hand, they are a way to draw physicians’ attention on new diseases, and on the other, their role in education and quality control is undeniable.

Case reports in respiratory care.

The essential components of a case report, important issues of patient confidentiality, and how authorship should be determined are discussed, and 10 common pitfalls in case report writing are described.

Publication of case reports: Is consent required?

Case reports in medicine are fundamentally individual patient stories generally describing unique or unexpected findings in terms of disease or treatment, and standards have been evolving in law and ethics such that consent should now be viewed as mandatory.

When N = 1: the role of the case report.

The role of a case report in an evidence-based world is that it should motivate the reader to gather more evidence, and case reports should be published when they meet at least 1 of 4 criteria.

Why should medical editors CARE about case reports?

The role of case reports has outgrown its primary purpose; in its beginnings, case reports were intended to identify clinical novelty, afterwards authors used them as a means to alert about adverse reactions and highlight innovations, while today they play a significant role in medical education and help emphasize ethical predicaments.

Using Cases to Establish Novel Diagnoses: Creating Generic Facts by Making Particular Facts Travel Together

In contemporary medicine, cases may offer what is considered to be fairly definitive evidence in modern scientific terms, especially, for instance, with regard to unusual or unexpected occurrences such as adverse drug reactions.

The context is the ‘news’ in healthcare improvement case reports

  • D. Stevens
  • Medicine
    Quality and Safety in Health Care
  • 2010
If crafted too broadly, it runs the risk of backsliding from efforts to bring order to the heterogeneity in quality improvement implementation reports, and a narrowed definition could enhance signal and reduce noise in the expanding scholarly literature.



Case reports in an evidence-based world

The case report is as necessary as ever for the progress of medical science and the practice of medicine, and confrontation with the evidence-based medicine movement has taught us its proper role.

Effective Care in Pregnancy and Childbirth

  • D. Paintin
  • Medicine
    British journal of obstetrics and gynaecology
  • 1990
Effective Care in Pregnuncy and Childbir/h, edited by Chalmers, Enkin and Keirse, is probably the most important book in obstetrics to appear this century and its value to the profession will be profound and long lasting.

Clinical Case Reporting in Evidence-based Medicine

The importance of modern case reporting on medical casuistics and how to prepare a single case report is discussed.

False-positives in spontaneous reporting: should we worry about them?

For rare events, reports of coincidental drug-event associations are too unlikely to be considered as an important limitation of spontaneous reporting, and the proposed method based on the Poisson distribution is suggested.

Validity of anecdotal reports of suspected adverse drug reactions: the problem of false alarms

Criteria for assessing the validity of first reports of suspected adverse reactions should include: reactions on rechallenge, a pharmacological basis for the adverse reaction, immediate acute reactions, local reactions at the site of administration, reactions with a new route of administration of a drug known to provoke such reactions by another route, and the repeated occurrence of very rare events.

The Empirical Basis for the Discovery of New Therapies

  • J. Goodwin
  • Psychology
    Perspectives in biology and medicine
  • 1991
It is argued that the discovery of new therapies has always been and will continue to be an empirical science and the vast majority of efficacious ancient and modern drugs were discovered and initially used without any understanding of how they work.

Choosing the best research design for each question

The appropriate study architecture, strategy, and tactics are those that identify and characterise the reactions of individual patients to their disease and their assessments of the risks and benefits of alternative treatments through open ended, in depth interviews with emphasis on variations in preferences among individuals.

Factor V Leiden and fatal pulmonary embolism.

It is concluded that in the presence of severe illness, the factor V Leiden mutation plays no additional role in the development of pulmonary emboli, and the relative risk of the very rare fatal pulmonary embolus that is the sole cause of death might also be less than therelative risk for deep-vein thrombosis in carriers of the factorV Leiden mutations.

A prospective study of risk factors for pulmonary embolism in women.

It is indicated that obesity, cigarette smoking, and hypertension are associated with increased risk of pulmonary embolism in women and control of these risk factors will decrease risks of pulmonaryembolism as well as coronary heart disease.